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The topic of cultural competence has become more prominent in the global dialogue regarding healthcare quality. According to the most recent census data, the United States population is diversifying even more quickly than anticipated, which has resulted in a rapidly changing range of healthcare needs, belief systems, language barriers, and other issues.
Patients from culturally and linguistically diverse backgrounds (CALD) have been shown to have worse health outcomes and less access to healthcare. It has been demonstrated that these differences persist even in cases where the medical conditions of the CALD population are comparable to those of English-speaking patients. Language, communication styles, beliefs, attitudes, and behaviors that make it difficult to communicate with the health system are partly to blame for these disparities.

To improve health care in the United States, the Office of Minority Health, Department of Health and Human Services, established national standards for culturally and linguistically appropriate services in health and health care.
To accomplish this, health services must help clinicians comprehend how patients from a variety of backgrounds view their illness’s cause and prognosis, describe their symptoms, comprehend the course of treatment, and view their place in the world.
In this article let us discuss the need for cultural competence in healthcare, the ways to achieve this, and the barriers to implementation.

Necessity of Cultural Competence in Healthcare

Cultural competence has become one of the most needed parts of the healthcare system to ensure quality care. Let’s explore them one by one.

Equity in Access to Care: The need of the hour

The provision of healthcare services that are both accessible and adapted to the needs of various populations is ensured by cultural competence. Healthcare providers can address disparities in healthcare utilization and remove access barriers by acknowledging and valuing cultural differences.
Healthcare professionals can better serve patients’ needs and promote positive health outcomes by addressing cultural factors that affect treatment adherence and health behaviors.

Cultural Competence and Patient Safety

Patient safety is one area where disparities exist in healthcare. For instance, patients with limited English proficiency were more likely than their English-proficient counterparts to experience adverse events, and the harm was more likely to be severe, according to a study that examined hospitals across the nation.
In another study published in the journal “Hospital Pediatrics”, hospitalized Latino children were more likely to experience an adverse event than non-Latino White children.
In one instance, it was not realized that an Asian woman in the hospital would speak to anyone unless a male family member was present, which caused a delay in getting permission for an essential surgery.

Legal and Ethical Imperatives

The importance of cultural competence in healthcare as a moral and legal requirement is growing. In order to adhere to ethical standards of patient-centered care and to comply with laws like the Civil Rights Act, healthcare organizations must provide services that are appropriate for the patient’s culture and language.

Globalization and Diversity

Cultural competency is more crucial than ever in a world that is becoming more diverse and interconnected. Healthcare professionals must be ready to work with patients from a variety of cultural backgrounds, such as immigrants, refugees, and members of underrepresented groups.

Ensuring cultural competence in healthcare: Key Implementations

There are several strategies through which cultural competence can be brought into healthcare. Let’s see how they can bring equity to quality care.

Ensuring linguistic accessibility

One way to get around language barriers is through language assistance, which can be provided by qualified interpreters in foreign languages and American Sign Language as well as bilingual clinicians and staff. The availability of sufficient interpreter services, guidelines for their use, and instruction on how to use and collaborate with interpreters are necessary for successful language assistance.

According to research published in “Journal for Healthcare Quality”, a few examples of documented patient safety events resulting from a lack of timely language assistance include, performing an x-ray on the incorrect part of the body, falls caused by patients who don’t know how to ask for help, and the inability to treat patients in emergency rooms because medical histories or medication lists weren’t obtained.

Providing Cultural Brokers

Enhancing cultural competence in healthcare can be achieved, in part, by using a cultural broker. The process of mediating between a patient’s traditional health beliefs and practices and the healthcare system is known as cultural brokerage.
The function of a cultural broker can be fulfilled by interpreters, community health workers, and patient navigators by offering context and acting as a partner for the patient and the provider. Cultural brokers must be adept at navigating the healthcare system and possess in-depth knowledge of the cultural group they represent, even though their exact roles may change based on the needs of patients and providers.

Re-Engineered Discharge (RED) Toolkit

Researchers at the Boston University Medical Center (BUMC) developed a set of 12 actions that hospitals should take during and after the patient’s stay to improve their discharge process. The latest version of the RED Toolkit offers guidelines on how to implement the RED to patients who have different cultural backgrounds, languages, racial and ethnic backgrounds, levels of literacy, sexual orientations, gender identities, and other characteristics.
Furthermore, the toolkit illustrates how the implementation of each RED component may need to be adjusted for a variety of patient populations. Studies have demonstrated that the RED is successful in lowering post-hospital visits and readmissions.

Implementing the AHRQ Proficiency Module

Hospitals can create and implement a plan to train clinical staff and interpreters in teamwork skills, particularly when working with patients who speak limited English. This can be achieved by using modules developed by the Agency for Healthcare Research and Quality (AHRQ).

Hospitals should follow the recommendations in the AHRQ guide Improving Patient Safety Systems for Limited-English-Proficient (LEP) Patients. These recommendations include:

  • fostering a supportive culture for the safety of diverse patients
  • modifying current systems to better identify medical errors among patients with LEP;
  • improving the reporting of medical errors for LEP patients;
  • routinely monitoring patient safety for LEP patients; and
  • addressing root causes to prevent medical errors among LEP patients.

Barriers to Cultural Competence in Health Care

Promoting cultural competence can present challenges. Some of the barriers to cultural competence in health care include:

Adequate Knowledge of an Organization’s Cultural Competence

To successfully address cultural competence, healthcare organizations need to first gauge their current performance. This involves answering questions such as:

  • Where does the organization fall short in providing language accessibility?
  • Where do care disparities exist within the system?

Leadership is unable to allocate its efforts and resources effectively if it does not know where the gaps are.
Therefore, in addition to tracking disparities, healthcare organizations that prioritize cultural competence must gather information about the racial and ethnic backgrounds, language preferences, and sexual orientations of their patients. Surveys of patients can also provide information about how culturally competent an organization is.

Limited Resources to Support Cultural Competence

It takes resources to realize cultural competence in healthcare. Establishing the infrastructure needed to elevate cultural competence beyond a value requires a commitment of time, resources, and leadership from organizations.
This entails setting aside money, among other things:

  • Linguistically diverse materials
  • Interpreters
  • Cultural competence training
  • Diverse staff recruitment programs

Though prioritizing cultural competence comes with a price tag, it ultimately offers an essential return on investment.

To Conclude

Addressing inequities in healthcare delivery and advancing health equity depends on providing care that is culturally competent. We can improve access, communication, and understanding in healthcare settings by incorporating cultural competence into technology design. This will eventually improve outcomes for all people, regardless of their cultural background.
Codewave understands that adopting diversity and inclusivity in technology design is a path to more efficient and patient-centered healthcare—it’s not just a question of moral obligation.

At Codewave EIT, we are always there to provide technological interventions for your healthcare organization that pave the way to competent care. Our AI-driven solutions can help you make patient-centric decisions that ultimately pave the way to culturally competent care for all. Codewave EIT’s XAI sheds light on the inner workings of algorithms, demystifying their decision-making processes and revealing the biases that can creep in. In essence, our XAI solutions can unlock the black box of AI, allowing us to peer inside and ensure fairness. To stay updated, please feel free to talk to our team and explore our range of solutions.